Modeling the Synergistic Impact of Yttrium 90 Radioembolization and Immune Checkpoint Inhibitors on Hepatocellular Carcinoma.

The impact of yttrium 90 radioembolization (Y90-RE) in combination with immune checkpoint inhibitors (ICIs) has recently gained attention. However, it is unclear how sequencing and dosage affect therapeutic efficacy. The purpose of this study was to develop a mathematical model to simulate the synergistic effects of Y90-RE and ICI combination therapy and find the optimal treatment sequences and dosages. We generated a hypothetical patient cohort and conducted simulations to apply different treatments to the same patient. The compartment of models is described with ordinary differential equations (ODEs), which represent targeted tumors, non-targeted tumors, and lymphocytes. We considered Y90-RE as a local treatment and ICIs as a systemic treatment. The model simulations show that Y90-RE and ICIs administered simultaneously yield greater benefits than subsequent sequential therapy. In addition, applying Y90-RE before ICIs has more benefits than applying ICIs before Y90-RE. Moreover, we also observed that the median PFS increased up to 31~36 months, and the DM rates at 3 years decreased up to 36~48% as the dosage of the two drugs increased (p < 0.05). The proposed model predicts a significant benefit of Y90-RE with ICIs from the results of the reduced irradiated tumor burden and the associated immune activation and suppression. Our model is expected to help optimize complex strategies and predict the efficacy of clinical trials for HCC patients.

Relationship Between Community Resilience and Quality of Life of Disaster-Affected People: Reinforcement Effects of the Perception of Government Relief Services in South Korea.

OBJECTIVE: The occurrence of various forms of disasters has increased worldwide. In South Korea, community resilience is particularly emphasized, especially in response to large-scale disasters in regional and group units. This study investigated the association between community resilience and the quality of life of disaster-affected people, and identified the moderating effects of perception of government relief services. METHODS: Data from the third long-term survey on the change of life of disaster-affected people conducted in 2018 by the National Disaster Management Research Institute were used. The study selected 1046 participants ages ≥ 19 years from among the disaster-affected people. Statistical analyses were performed using Model 1 of the PROCESS Macro 4.0 in the SPSS program. RESULTS: Community resilience positively affected disaster-affected people's quality of life. The perception of government relief services significantly strengthened the association between community resilience and quality of life. CONCLUSIONS: The study highlights the importance of enhancing community resilience to improve disaster-affected people's quality of life and emphasizes the role of perception of government relief services in reinforcing this relationship. Several practical and political measures that focus on improving community resilience and perception of government relief services are suggested to enhance disaster-affected people's quality of life.

Mathematical prediction with pretreatment growth rate of metastatic cancer on outcomes: implications for the characterization of oligometastatic disease.

Background: Oligometastatic disease (OMD) represents an indolent cancer status characterized by slow tumor growth and limited metastatic potential. The use of local therapy in the management of the condition continues to rise. This study aimed to investigate the advantage of pretreatment tumor growth rate in addition to baseline disease burden in characterizing OMDs, generally defined by the presence of ≤ 5 metastatic lesions. Methods: The study included patients with metastatic melanoma treated with pembrolizumab. Gross tumor volume of all metastases was contoured on imaging before (TP-1) and at the initiation of pembrolizumab (TP0). Pretreatment tumor growth rate was calculated by an exponential ordinary differential equation model using the sum of tumor volumes at TP-1 and TP0 and the time interval between TP-1. and TP0. Patients were divided into interquartile groups based on pretreatment growth rate. Overall survival, progression-free survival, and subsequent progression-free survival were the study outcomes. Results: At baseline, median cumulative volume and number of metastases were 28.4 cc (range, 0.4-1194.8 cc) and 7 (range, 1-73), respectively. The median interval between TP-1 and TP0 was -90 days and pretreatment tumor growth rate (×10-2 days-1) was median 4.71 (range -0.62 to 44.1). The slow-paced group (pretreatment tumor growth rate ≤ 7.6 ×10-2 days-1, the upper quartile) had a significantly higher overall survival rate, progression-free survival, and subsequent progression-free survival compared to those of the fast-paced group (pretreatment tumor growth rate > 7.6 ×10-2 days-1). Notably, these differences were prominent in the subgroup with >5 metastases. Conclusion: Pretreatment tumor growth rate is a novel prognostic metric associated with overall survival, progression-free survival, and subsequent progression-free survival among metastatic melanoma patients, especially patients with >5 metastases. Future prospective studies should validate the advantage of disease growth rate plus disease burden in better defining OMDs.

Music Perception Abilities of the Hearing Amplification System Users.

BACKGROUND AND OBJECTIVES: Recently, the improvement of music perception abilities for emotional stability and high quality of life has become important for the hearing loss group. This study aimed to examine and compare the music perception abilities of the normal hearing (NH) and hearing amplification system (HAS) groups to find the needs and methods of music rehabilitation. Subjects and. METHODS: The data were collected from 15 NH adults (33.1±11.4 years) and 15 HAS adults (38.7±13.4 years), of whom eight wore cochlear implant [CI] systems and seven wore CI and hearing aid systems depending on pitch, melody, rhythm, timbre, emotional reaction, and harmony perception tests. A mismatch negativity test was also conducted, and attitudes toward and satisfaction with listening to music were measured. RESULTS: The correction percentages for the NH and HAS groups were 94.0%±6.1% and 75.3%±23.2% in the pitch test; 94.0%±7.1% and 30.3%±25.9% in the melody test; 99.3%±1.8% and 94.0%± 7.6% in the rhythm test; 78.9%±41.8% and 64.4%±48.9% in the timbre test; 96.7%±10.4% and 81.7%±16.3% in the emotional reaction test; and 85.7%±14.1% and 58.4%±13.9% in the harmony test, respectively, showing statistical significance (p<0.05). For the mismatch negativity test, the area of the waveform was smaller in the HAS groups than in the NH groups, with 70 dB of stimulation showing no statistical significance. The response rates for satisfaction with listening to music were 80% and 93.3% for the NH and HAS groups, showing no statistical significance. CONCLUSIONS: Although the HAS group showed lower music perception ability than the NH group overall, they showed a strong desire for music listening. Also, the HAS group revealed a higher degree of satisfaction even when listening to unfamiliar music played with unusual instruments. It is suggested that systematic and constant musical rehabilitation based on musical elements and different listening experiences will improve music perception qualities and abilities for HAS users.

Exploring ideal operative time for best outcomes in gastric cancer surgery: A multi-institutional study based on KLASS-07 database.

Objective: While a rushed operation can omit essential procedures, prolonged operative time results in higher morbidity. Nevertheless, the optimal operative time range remains uncertain. This study aimed to estimate the ideal operative time range and evaluate its applicability in laparoscopic cancer surgery. Methods: A prospectively collected multicenter database of 397 patients who underwent laparoscopic distal gastrectomy were retrospectively reviewed. The ideal operative time range was statistically calculated by separately analyzing the operative time of uneventful surgeries. Finally, intraoperative and postoperative outcomes were compared among the shorter, ideal, and longer operative time groups. Results: The statistically calculated ideal operative time was 135.4-165.4 min. The longer operative time (LOT) group had a lower rate of uneventful, perfect surgery than the ideal or shorter operative time (IOT/SOT) group (2.8% vs. 8.8% and 2.2% vs. 13.4%, all P<0.05). Longer operative time increased bleeding, postoperative morbidities, and delayed diet and discharge (all P<0.05). Particularly, an uneventful, perfect surgery could not be achieved when the operative time exceeded 240 min. Regardless of ideal time range, SOT group achieved the highest percentage of uneventful surgery (13.4%), which was possible by surgeon's ability to retrieve a higher number of lymph nodes and perform ≥150 gastrectomies annually. Conclusions: Operative time longer than the ideal time range (especially ≥240 min) should be avoided. If the essential operative procedure were faithfully conducted without compromising oncological safety, an operative time shorter than the ideal range leaded to a better prognosis. Efforts to minimize operative time should be attempted with sufficient surgical experience.

Factors affecting social isolation among the young adults in South Korea: A cross-sectional analysis.

The recent increase in lonely deaths among young people has emphasized the emergence of social isolation as a social problem. This study investigated the issue of social isolation by examining multidimensional factors that affect social isolation and evaluating the subjective and objective dimensions of young adults. Data for this study were collected for 8 days (February 7-14, 2022) through an online questionnaire survey by a professional survey agency, based on proportional allocation of the young adult population (age 19-39 years); data from 521 young adults were analyzed. Regression analysis was performed using SPSS to identify multidimensional factors (relative deprivation, future outlook, depression, self-esteem, social skills, experience of violence, and online activity) that affect social isolation and showed that: (1) among sociodemographic characteristics, higher age and unemployment were associated with greater social isolation; (2) sociopsychological characteristics, such as higher levels of relative deprivation and depression, more negative future outlook, and lower self-esteem, all correlated with greater social isolation; and (3) among relationship characteristics, lower social skills and a stronger history of experiencing violence were linked to greater social isolation. These results highlight the need for a customized support system at the national level that takes into account the developmental tasks of young adults as a preventive strategy to solve the problem of social isolation of young adults and to devise various strategies to provide them with mental health services.

Effects of Natural Versus Synthetic Consonant and Vowel Stimuli on Cortical Auditory-Evoked Potential.

BACKGROUND AND OBJECTIVES: Natural and synthetic speech signals effectively stimulate cortical auditory evoked potential (CAEP). This study aimed to select the speech materials for CAEP and identify CAEP waveforms according to gender of speaker (GS) and gender of listener (GL). SUBJECTS AND METHODS: Two experiments including a comparison of natural and synthetic stimuli and CAEP measurement were performed of 21 young announcers and 40 young adults. Plosive /g/ and /b/ and aspirated plosive /k/ and /p/ were combined to /a/. Six bisyllables-/ga/-/ka/, /ga/-/ba/, /ga/-/pa/, /ka/-/ba/, /ka/-/pa/, and /ba/-/pa/-were formulated as tentative forwarding and backwarding orders. In the natural and synthetic stimulation mode (SM) according to GS, /ka/ and /pa/ were selected through the first experiment used for CAEP measurement. RESULTS: The correction rate differences were largest (74%) at /ka/-/ pa/ and /pa/-/ka/; thus, they were selected as stimulation materals for CAEP measurement. The SM showed shorter latency with P2 and N1-P2 with natural stimulation and N2 with synthetic stimulation. The P2 amplitude was larger with natural stimulation. The SD showed significantly larger amplitude for P2 and N1-P2 with /pa/. The GS showed shorter latency for P2, N2, and N1-P2 and larger amplitude for N2 with female speakers. The GL showed shorter latency for N2 and N1-P2 and larger amplitude for N2 with female listeners. CONCLUSIONS: Although several variables showed significance for N2, P2, and N1-P2, P1 and N1 did not show any significance for any variables. N2 and P2 of CAEP seemed affected by endogenous factors.

Occupational Performance of Hearing-Impaired and Normal-Hearing Workers in Korea.

BACKGROUND AND OBJECTIVES: This study aimed to investigate the occupational performance of Korean workers with and without hearing loss and analyze the hearing-related difficulties in the working environment. SUBJECTS AND PURPOSE: The Amsterdam checklist for hearing and work was used for the analyses and the occupational environments of the Korean workers were investigated. Out of 129 total participants, 86 workers experienced severe to profound hearing loss and 43 had the normal hearing ability. The hearing-impaired workers were recruited from two leading vocational centers and normal-hearing workers were their colleagues. RESULTS: The hearing-impaired workers were found to take fewer sick leaves and exhibited higher rates of permanent job statuses compared to the normal-hearing workers. Workers with hearing loss rarely detected background sound; however, they could perceive reverberation more frequently. They felt more satisfied with their careers than the normal hearing workers as they received social support and needed to put their effort into hearing for most hearing activities. Furthermore, the effort in hearing increased with the increase in job demand, job control, social support, and career satisfaction. The working hours per week increased with the increase in age, education level, job demand, job control, and social support. Different trends were observed in 9 out of 12 variables while comparing the data from the present study with that obtained from the hearing-impaired workers of the Netherlands, indicating a large difference between countries. CONCLUSIONS: Although the hearing-impaired Korean workers operate diligently with good job positions, it is necessary to enhance their acoustic environment and provide them social support. Considering the cultural background of the hearing-impaired workers, the development of suitable vocational rehabilitation programs and specific questionnaires is strongly recommended worldwide.

A Review of Contemporary Teleaudiology: Literature Review, Technology, and Considerations for Practicing.

The scope of teleaudiology has been noted with telehealth due to Coronavirus disease (COVID-19) recently. As the notion has been around us for more than 20 years ever since 1999, it is necessary to perceive the knowledge accurately and prepare for the successful implementation of it. Therefore, the literature review including screening and diagnostic audiometry, cochlear implants and hearing aids, and aural rehabilitation, telecommunications technology regarding several fields of teleaudiology, and considerations for practicing were identified. Although overall internet-based audiological services showed benefits in terms of outcome and accessibility, uncertainties of cost-effectiveness, the optimal level of support, and a need for further studies of many aspects for teleaudiology has arisen. In the view of technology, the store-and-forward (asynchronous/hybrid) and a real-time (synchronous) methods were introduced with one applied and nine registered patents recorded from 2004 to 2020 for the invention of teleaudiology in the United States. Also, 10 checklists were suggested for planning teleaudiology practice from prior experience in hosting the teleaudiology program. Conclusively, it is hoped that this review sheds light on recognizing and improving the existing teleaudiology services and helps overcome the challenges faced in the era of pandemic and untact world to come.

Organizing an in-class hackathon to correct PDF-to-text conversion errors of Genomics & Informatics 1.0.

This paper describes a community effort to improve earlier versions of the full-text corpus of Genomics & Informatics by semi-automatically detecting and correcting PDF-to-text conversion errors and optical character recognition errors during the first hackathon of Genomics & Informatics Annotation Hackathon (GIAH) event. Extracting text from multi-column biomedical documents such as Genomics & Informatics is known to be notoriously difficult. The hackathon was piloted as part of a coding competition of the ELTEC College of Engineering at Ewha Womans University in order to enable researchers and students to create or annotate their own versions of the Genomics & Informatics corpus, to gain and create knowledge about corpus linguistics, and simultaneously to acquire tangible and transferable skills. The proposed projects during the hackathon harness an internal database containing different versions of the corpus and annotations.